Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
MATRIX 12.5X10CM 125SQ CM RESTRATA SOFT NONFRIABLE ABSORBABLE WOUND STERILE LATEX FREE WHITE
The hospitals that file a Aetna Better Health rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.
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41 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | BELTON REGIONAL MEDICAL CENTER Kansas City, MO percent of total billed charges · outpatientfrom % of charges | 1 | $65.10 | $31.41 – $102.00 |
| 2 | Capital Health System Inc Trenton, NJ percent of total billed charges · outpatientfrom % of charges | 1 | $987.59 | $325.51 – $2,559 |
| 3 | Capital Health System Inc Browns Mills, NJ percent of total billed charges · outpatientfrom % of charges | 1 | $987.59 | $325.51 – $2,559 |
| 4 | Carle BroMenn Medical Center Normal, IL fee schedule · inpatient | 1 | $38.84 | $38.84 – $38.84 |
| 5 | Carle BroMenn Medical Center Normal, IL fee schedule · outpatient | 1 | $38.84 | $38.84 – $38.84 |
| 6 | Carle Eureka Hospital Eureka, IL fee schedule · inpatient | 1 | $38.84 | $38.84 – $38.84 |
| 7 | Carle Eureka Hospital Eureka, IL fee schedule · outpatient | 1 | $38.84 | $38.84 – $38.84 |
| 8 | CentraState Medical Center Freehold Township, NJ percent of total billed charges · bothfrom % of charges | 1 | $6,541 | $1,820 – $18,218 |
| 9 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $3,216 | $2,268 – $4,163 |
| 10 | Chilton Medical Center Pompton Plains, NJ percent of total billed charges · bothfrom % of charges | 1 | $974.31 | $974.31 – $974.31 |
| 11 | Henry Ford Health System West Bloomfield, MI facility · fee schedule · outpatient | 1 | $67.82 | $67.82 – $67.82 |
| 12 | Henry Ford Health System Plymouth, MI facility · fee schedule · outpatient | 1 | $67.82 | $67.82 – $67.82 |
| 13 | Henry Ford Macomb Hospital Corporation Clinton Twp, MI facility · fee schedule · outpatient | 1 | $67.82 | $67.82 – $67.82 |
| 14 | Henry Ford Wyandotte Hospital Brownstown Charter Twp., MI facility · fee schedule · outpatient | 1 | $67.82 | $67.82 – $67.82 |
| 15 | Hoopeston Community Memorial Hospital Hoopeston, IL fee schedule · inpatient | 1 | $38.84 | $38.84 – $38.84 |
| 16 | Hoopeston Community Memorial Hospital Hoopeston, IL fee schedule · outpatient | 1 | $38.84 | $38.84 – $38.84 |
| 17 | LEE'S SUMMIT MEDICAL CENTER Lee's Summit, MO percent of total billed charges · outpatientfrom % of charges | 1 | $68.15 | $26.81 – $129.44 |
| 18 | MENORAH MEDICAL CENTER Overland Park, KS percent of total billed charges · outpatientfrom % of charges | 1 | $50.98 | $0.30 – $89.36 |
| 19 | Methodist Medical Center of Illinois Peoria, IL fee schedule · inpatient | 1 | $38.84 | $38.84 – $38.84 |
| 20 | Methodist Medical Center of Illinois Peoria, IL fee schedule · outpatient | 1 | $38.84 | $38.84 – $38.84 |
| 21 | Morristown Medical Center Morristown, NJ percent of total billed charges · bothfrom % of charges | 1 | $1,110 | $1,110 – $1,110 |
| 22 | Norton Hospitals INC Louisville, KY percent of total billed charges · outpatientfrom % of charges | 1 | $4,913 | $657.97 – $15,971 |
| 23 | Norton Hospitals INC Louisville, KY percent of total billed charges · outpatientfrom % of charges | 1 | $4,913 | $657.97 – $15,971 |
| 24 | Norton Hospitals INC Louisville, KY percent of total billed charges · outpatientfrom % of charges | 1 | $4,913 | $657.97 – $15,971 |
| 25 | Norton Hospitals INC Louisville, KY percent of total billed charges · outpatientfrom % of charges | 1 | $4,913 | $657.97 – $15,971 |
← Payers reporting HCPCS A2007 · Snapshot 20261109T115250Z-6452cf6e